Provider Demographics
NPI:1124295043
Name:SMART, SHERRIE A (NP)
Entity type:Individual
Prefix:
First Name:SHERRIE
Middle Name:A
Last Name:SMART
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:SHERRIE
Other - Middle Name:A
Other - Last Name:ADLER-GRIBBLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:76 UNDERWOOD ST STE 200
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32806-1110
Mailing Address - Country:US
Mailing Address - Phone:321-841-3500
Mailing Address - Fax:321-843-8777
Practice Address - Street 1:76 UNDERWOOD ST STE 200
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-1110
Practice Address - Country:US
Practice Address - Phone:321-841-2800
Practice Address - Fax:321-843-8777
Is Sole Proprietor?:No
Enumeration Date:2008-05-09
Last Update Date:2025-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF335602-1363L00000X
FLAPRN11035380363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03013870Medicaid
NYJ400126488Medicare PIN